| NPI | 1841699808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE DUEWEL Manager 816-523-6644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: KS 16-4415) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MO 900987) |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2021-06-10 |